Here's what we now know about "female Viagra"

Update (June 13th, 2018): Flibanserin, the drug known as “female Viagra,” got a lot of press back in 2015 when it was first approved by the F.D.A., but then it kind of disappeared. Its manufacturer, Sprout Pharmaceuticals, sold to another company. But then that company went through some major turmoil, leading few pharmacies to carry the pink pill. But now, Sprout is back in the hands of its original founder, Cindy Eckert, and she’s brought Addyi — the brand name for flibanserin — to market.

Since June 11th, Addyi has been available online through a telemedicine service, and costs $99 per month at most for those without insurance (the price is around $25/month with insurance coverage); there’s also a $75 one-time consultation fee for your visit with the telemedicine doctor. That’s a far cry from the drug’s previous price — around $800 per month. There’s a strict warning on the box that Addyi is not to be used by women who drink, since the drug has been shown to interact negatively with alcohol.

Advocates for the drug say it helps return women who suffer from a lack sexual desire to a “normal” level of interest (what’s “normal” is defined by each woman) and treats what has been, until Sprout began its quest to bring Addyi to market, an invisible condition.

Katherine Campbell, a mother of three who says she lost her desire for sex after her first child, went on Addyi right after it was approved. She told Bloomberg, “After about a week and a half, two weeks, of using it, I noticed a difference. It was modest, it was subtle, but for me it meant I went from maybe having sex zero times, maybe once every three months, to about once or twice a month…It didn’t turn me into some kind of sex-crazed nympho, but here I am: I’m still married, I have a third kid.”

Critics, though, say the drug was pushed to market despite noted risks (read more on that below) and think the drug pathologizes the natural ebb and flow of a woman’s sexual desire. The real issue, they say, is a sexist social assumption that women should experience desire in the same way that men do.

Previously (August 17th, 2015):

The Food and Drug Administration is expected to make a decision on the approval of flibanserin, “the world’s first drug designed to boost a woman’s sexual desire” (it’s been called the “female Viagra,” but that’s not quite accurate — more on that later). To give you some perspective on the issue, medication designed to boost a man’s sexual desire has been around since 1953 with the introduction of Delatestryl, an injectable testosterone hormone replacement (Viagra, meanwhile, has been around since 1998). Yes, that means that if flibanserin is approved, the pharmaceutical industry will have waited 62 years after addressing this problem for men to address this same concern for women.

That sexism runs rampant in pharmaceuticals should come as no surprise to any of us. The female birth control pill was approved by the FDA in 1960, but we’re still waiting on the equivalent for men, i.e. a treatment that would make men equally responsible for family planning. Vasalgel, a polymer contraceptive that is injected directly into the vas deferens of the penis, should be on the market by 2017, following female birth control by 57 years. (Editor’s note: In 2018, Vasalgel is still years away from hitting the market, if it ever happens.)

That all said, the pharmaceutical industry is finally giving female sexual desire the attention it deserves. Flibanserin is designed to treat hypoactive sexual desire disorder (HSDD) in premenopausal women, or, in other words, women who are distressed by their low sexual desire (it’s worth noting that HSDD was removed from the American Psychiatric Association’s diagnostic manual in 2010, though doctors continue to treat its symptoms).

Though flibanserin is being touted as the “female Viagra,” the drug works very differently from Viagra. Viagra increases blood flow to the groin, enabling what is physically required for sex in men — an erection. Meanwhile, flibanserin affects the central nervous system by increasing chemicals like dopamine and two different kinds of serotonin. Also, as the International Business Times reports, whereas Viagra gives men results within 45 minutes, women may be taking flibanserin for as long as eight weeks before they experience peak results.

Those “peak results” also aren’t exactly dramatic. During trials, women who took flibanserin reported an average of 4.4 satisfying sexual sessions a month, compared to the 3.7 sessions experienced by placebo takers and the 2.7 experiences women were experiencing prior to the trial (those were median results, though, and women who did experience positive results from flibanserin said they were much more dramatic). This is one of the reasons why two past FDA panels have denied approval to flibanserin since the drug began seeking FDA approval in 2010.

Not to pile on with the not-great news, but it’s also important to point out that there are still safety concerns surrounding the drug, which has been known to cause fainting, nausea, and low blood pressure. Even the FDA members who are in favor of the drug’s approval have warned flibanserin’s manufacturer, Sprout Pharmaceuticals Inc., that these aren’t acceptable “side effects,” and these issues would have to be dealt with in a responsible way before the drug could be approved.

There’s one more issue: In FDA-required clinical trials, new drugs must be tested to see how they interact with alcohol. Flibanserin was given to 23 men and two men (even though it’s a drug meant for women); some had low blood pressure and others felt faint.

That all said, whether or not flibanserin is approved, it’s a good thing that we’re talking about women’s sexual desire. The jury’s still out on flibanserin, but women who want it should have the choice to take medicine that can help them.